Susan Starbuck Jordan, RNC, FNP
Individual provider Active NPI Family Nurse Practitioner · Hixson, TN
NPI 1427047331 · NPPES record last updated Jun 7, 2023
Key facts
- NPI
- 1427047331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APN0000006289 (TN)
- Practice address
- 1039 Executive Dr Ste 101
Hixson, TN 37343-7900 - Phone
- (423) 874-0125
- Fax
- (423) 874-0154
- NPI assigned
- Oct 14, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN0000006289 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ringgold Pediatric Clinic, P.C. | Past | Accepting new patients |
Interoperability endpoints
- susan.jordan.1@29980.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APN0000006289 | TN | Yes |
Addresses
Primary practice location
1039 Executive Dr Ste 101
Hixson, TN 37343-7900
Mailing address
6530 Lakeshore Pkwy
Chattanooga, TN 37416-1207
Phone (423) 316-3085
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103I501689 | Medicaid | GA | |
| Q008621 | Medicaid | TN |
Other providers in Hixson, TN
- Donald Lewis Jones
- Lisa Whiteford Jones
- Patricia P Jones
- Sarena Jones
- Michael Eugene Jordan Jr.
- Florentina Enverga Juatco
- Joseph Julian
- K VA T Food Stores, Inc.
- K VA T Food Stores, Inc.
- Kyle Kaminski
All providers in Hixson, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.